The safety and efficacy of the trans-umbilical approach for pyloroplasty in the management of post-acid corrosive gastric outlet obstruction in children
| Autor: | Essam A. Elhalaby, Nezar Abd Erouf Abo Halawa, Hussam S. Hassan, Hisham A. Almetaher, Dina Shawky, Ismael E. Elhalaby |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acid corrosive injury lcsh:Surgery Pyloroplasty 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Medicine Circum-umbilical incision Antrum business.industry Wound dehiscence lcsh:RJ1-570 lcsh:Pediatrics Gastric outlet obstruction Endoscopic dilatation lcsh:RD1-811 Pylorus medicine.disease Surgery medicine.anatomical_structure Pediatrics Perinatology and Child Health Esophageal stricture Vomiting 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Annals of Pediatric Surgery, Vol 17, Iss 1, Pp 1-6 (2021) |
| ISSN: | 2090-5394 |
| DOI: | 10.1186/s43159-021-00073-z |
| Popis: | Background Gastric outlet obstruction (GOO) may follow acid corrosive ingestion. Several surgical techniques have been reported after the failure of endoscopic dilatation. The aim of this study was to evaluate the feasibility and safety of Heinecke-Mikulicz pyloroplasty (HMP) through a circum-umbilical skin incision in children with pyloric stricture after accidental acid corrosive ingestion. Results Seven patients were males and 4 were females, their ages ranged from 17 months to 6 years at the time of definitive treatment. The surgery was completed successfully in all patients through the circum-umbilical incision. Vertical extension of skin incision was needed in one patient. The pylorus was grossly affected in 9 patients. Both pylorus and gastric antrum were involved in 2 patients. Nine patients had an excellent postoperative course with the cessation of vomiting and progressive weight gain. One patient developed postoperative recurrent stricture treated by gastrojejunostomy. Another patient with associated esophageal stricture responded to repeated endoscopic dilatation for the esophageal stricture and pyloroplasty for the pyloric stricture. No surgical site infection or wound dehiscence occurred in any patient. Conclusion Heinecke-Mikulicz pyloroplasty through a circum-umbilical approach is both feasible and safe in the majority of children with post-acid corrosive GOO. It is associated with satisfactory wound healing and excellent cosmetic outcome. Different techniques are recommended in cases of severe pyloric stricture associated with significant proximal gastric antral scarring. |
| Databáze: | OpenAIRE |
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